Associations Between Social Support and Patient-Reported Outcomes in Hemodialysis Patients: Results from the TACcare Study.

BACKGROUND: End Stage Kidney Disease (ESKD) patients experience high symptom burden which has been associated with a negative impact on their interpersonal relationships. However, there is limited research exploring associations of social support and patient-reported outcomes among hemodialysis (HD) patients.

METHODS: The current study is a secondary, cross-sectional analyses of the sociodemographic and clinical correlates of perceived social support (Multidimensional Scale of Perceived Social Support; MSPSS) at baseline. The study examined the extent to which perceived social support is associated with pain, depression, fatigue, anxiety, sleep, and HRQoL (SF-12 Mental Component Score; MCS) and Physical Component Score; PCS)).

RESULTS: Of the 160 randomized patients: mean (SD) age was 58 ±14 years; years on dialysis was 4.1 + 4.2; 45% were female; 29% Black, 13% American Indian, 18% Hispanic; 88% had at least high school education; and 27% were married. Mean baseline levels of perceived social support were comparable to other chronically ill populations. At least a high school education (p = 0.04) and being married (p = 0.05) were associated with higher total MSPSS scores. Higher MSPSS scores were correlated with lower levels of fatigue (r = 0.21, p =0.008; higher fatigue scores signify lower fatigue), pain (r = -0.17, p = 0.03), depressive symptoms (r = -0.26, p < 0.001), anxiety (r = -0.23, p = 0.004), better sleep quality (r = -0.32, p < 0.001) and SF-12 MCS (r = 0.26, p <0.001). Moderation analyses revealed male sex and non-Hispanic ethnicity resulted in stronger positive associations of perceived social support with SF-12 MCS.

CONCLUSIONS: The level of perceived social support observed among thrice weekly HD patients in TACcare was similar to those observed in other chronic conditions. Because of the associations between perceived social support and patient-reported outcomes, particularly psychosocial and behavioral health outcomes, targeting social support appears to be warranted among HD patients.